Dan Swayze Pioneers Community Paramedicine Innovation and Healthcare Workforce Development

Dan Swayze, DrPH, MBA, MEMS, has been involved in emergency medical services for more than 30 years and is one of the earliest pioneers of community paramedicine.

"I started as a wannabe medical student and quickly realized that I wasn't going to be able to get into medical school. I had always been a part of a volunteer fire department with my dad in a very rural area in upstate New York. I grew up in the firehouse with him and was always attracted to serving in that capacity," said Swayze.

Swayze is currently the vice president of community services at UPMC. He formerly served as: Assistant vice president of Clinical Affairs, Community Support Services at UPMC; vice president and chief operating officer of the Center for Emergency Medicine of Western Pennsylvania for 16 years; an adjunct professor at the University of Pittsburgh; vice president of consumer health and wellness at Acclamation Systems, Inc.; and the director of health programs and director of prehospital care at UPMC.

Swayze has a doctorate degree in behavioral and community health services from University of Pittsburgh School of Public Health, a master's in business administration from University of Pittsburgh Katz School of Business, and a master's in emergency medical services from Drexel University.

From his earliest years in the profession, he saw how paramedics skills and passion weren't being used effectively to respond to the needs of the communities they served.

"Historically, we've trained paramedics to do emergency medical responses, which was absolutely essential when the ambulance service was first getting started in the United States. But the more that I got involved, the more I realized that there's a misalignment with the resources they have and the work that they're being asked to do. That is really what has driven my subsequent work on how we can use that workforce differently and in a more impactful way," Swayze said.

As a paramedic, Swayze realized he was drawn to the ability to impact one person's life at a time – a "one call, one life" kind of response. But due to many factors, including protocol, expertise, time, and resources, the needs of his patients weren't always being dialed into the right agency.

He harkens back to memories of a man who lived in a condemned building he owned who had multiple chronic illnesses, no support, and was often in and out of the hospital but struggled to care for himself because he was concerned for the well-being of his dog who had a concerning lump on its side. A call to a vet to do a pro-bono case and get the dog started on the medicine it needed also led to calls to get the patient set up with the care he needed and had a right to through the VA.

Swayze also recounted a PhD who called with symptoms of congestive heart failure. Upon a visit to the home, medics found that he was taking medications meticulously as prescribed by multiple doctors, who weren't aware of what the others were prescribing. That community health worker was able to remedy the situation before it was deadly.

"When you realize that people are calling 911 because they have a crisis of some kind but they just don't know who else to call, the 911 system has become the de-facto early emergent entry into any system of care – if you're homeless or food insecure or you have any challenge," Swayze said. "There is no other system of care that is as immediate and as responsive as the emergency medical system is.The problem is that it's the wrong system for most of those other types of crises. It wasn't designed to handle it."

Recognizing this issue as an opportunity, UPMC Health Plan's Freedom House 2.0 program was born.

Modeled from Pittsburgh's innovative 1960s initiative which recruited, trained, and employed economically disadvantaged individuals, the 2.0 reboot is a 10-week program training people from economically disadvantaged communities as emergency medical technicians and community health workers. Participants receive mentorship and financial support, as well as state approved EMT certification and training.

The first seven cohorts of students, approximately 100 students in total, that have graduated since 2020 are predominantly African American women from communities that are marginalized and impoverished. Until Freedom House 2.0, they had struggled to get their foot in the door of the healthcare system workforce as they deal with their own social determinants.

"What's unique about Freedom House 2.0 is that we recognize that the students that are in the classroom are experiencing the same trauma as the residents of the communities that we're trying to help. In order for them to be successful, we have to wrap around other social services into the classroom setting so that they can be successful," Swayze explained, adding that this means helping with food insecurity, childcare, transportation issues, and more.

With 60 to 80 percent of participants completing the program and being placed in EMS and clinical settings, it has proven to be a successful workforce pipeline for UPMC and regional health care more broadly.

As a result of this program and others, Swayze, and in turn Pittsburgh, are widely considered one of the earliest pioneers of community paramedicine, a model of community-based health care in which paramedics work outside their normal emergency response and transport roles to maximize the use of emergency care resources and enhance access to primary care for medically underserved populations. Several states have seen its success and enacted legislation enabling community paramedicine.

In addition to receiving several local and state EMS awards, in 2014 Swayze received national recognition from the Journal of Emergency Medical Services and Physio-Control as an EMS10: Innovators in EMS recipient for his work with the CONNECT Community Paramedic project in Pittsburgh.

Swayze has been a long-time friend, board member, and supporter of JHF. He was: A faculty member of the EMS Champions program; active with the Senior Champions program; attended the EMS Israel mission with Nancy Zionts and other EMS leaders in November of 2010; served on the Full Court Press on seniors from 2020-2022; and remains an active board member, serving on both the JHF board and the Health Careers Futures board.

"Karen and Nancy are so innovative in their approach. What I find from attending Board meetings and various learning collaboratives is they're so far out in front of so many important topics that you realize that if it's on their radar it's worth paying attention to. They tirelessly advocate for these important topics, support marginalized communities, and really make an impact. It's truly inspirational," Swayze said.

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